Mitral Stenosis

Recommendations for mitral stenosis are based on valve area size and the presence of signs or symptoms. Inquire about episodes of angina or syncope, fatigue, and the ability to perform tasks that require exertion.

Waiting period

Minimum — 4 weeks if post-percutaneous balloon mitral valvotomy

Minimum — 3 months if post-surgical commissurotomy

NOTE: If more than one waiting period applies (because of multiple cardiac conditions or other comorbid diseases), examine the driver for certification after the completion of the longest waiting period.

Decision

Maximum certification period — 1 year

Recommend to certify if:

The driver has:

• Mild mitral stenosis that is asymptomatic.
• Moderate mitral stenosis that is asymptomatic.
• Severe mitral stenosis and a clearance from a cardiovascular specialist who understands the functions and demands of commercial driving following:
  • Percutaneous balloon mitral valvotomy.
  • Surgical commissurotomy.

Recommend not to certify if:

The driver has severe mitral stenosis, until successfully treated.

Monitoring/Testing

The frequency of cardiovascular specialist evaluation depends on the development and severity of symptoms; however, it should be performed at least annually, including:

• Chest X-ray.
• Electrocardiogram.
• Two-dimensional echocardiography with Doppler or other mitral stenosis severity assessment.

Follow-up

The driver should have an annual medical examination.

Mitral Stenosis Recommendation Table (PDF)